County ACE program could expand healthcare coverage

To qualify for the Access Coverage Enrollment program, people must live or work in Ventura County and be between the ages of 19 and 64. Federal requirements also mandate they be U.S. citizens or legal permanent residents. For more information, call 981-5070 or visit http://ow.ly/3zFsP.

About 2,500 more uninsured Ventura County residents could be covered in a healthcare program expanding later this year because of new injections of federal funding, according to county officials.

Some 7,200 uninsured people are currently covered for doctor’s appointments, medication, hospitalizations and other care through the 3-year-old Access Coverage Enrollment program funded in part by the U.S. Centers for Medicare & Medicaid Services.

In November, California and federal officials announced funding for the county-run program and similar efforts to cover the uninsured across the state was being expanded as part of a $10 billion, five-year program called the Medi-Cal waiver.

The new agreement means Ventura County and the nine other counties that already have coverage programs can apply for funding to expand their efforts. Other counties have an opportunity to start their own programs aimed primarily at poor people who currently don’t qualify for insurance programs but will be covered by Medi-Cal or other programs in 2014 as part of federal healthcare reform.

That process kicks off today when state officials are scheduled to send notices to counties that have until some time in February to submit applications. The federal government and the California Department of Health Care Services are set to make final decisions in May. The new funding is expected to start in June.

Ventura County Health Care Agency officials have already announced their intent to apply to keep the program going. About 1,000 people are currently waiting to be accepted into ACE, bringing the program’s enrollment numbers to more than 8,000 people.

The coming expansion means the enrollment could grow by about 30 percent, said Terrie Stanley, a deputy director for the Ventura County Health Care Agency. Many of those new members will be people who currently make too much to qualify for Medi-Cal, don’t have children, aren’t disabled or don’t meet other requirements.

“It covers people who wouldn’t be able to get covered any other way,” she said.

The county’s current program covers people who make up to 200 percent of federal poverty guidelines, or about $21,660 for a single person. Much of the new federal funding is aimed at people who make less money — no more than about $14,400 for a single person.

Stanley said people who are currently in the program or are accepted before the new funding starts and meet the higher income limits would still qualify for coverage. She said the county also wants to continue accepting new people who make up to 200 percent of the federal poverty level, though the amount of expansion will depend on funding.

“It’s our intent that we’ll be able to serve who we currently serve and hopefully expand beyond that as well,” she said.

Many details of the new program are still being formulated, including exactly how much more money is expected from the federal government, but it will be more than the current $10 million a year allocated to the county, Stanley said. The county will have to continue to contribute some matching funds but the exact amount is still being determined.

The program isn’t free for members. People pay an annual enrollment that ranges up to $200 as well as co-pays that include $15 for primary care and $75 for the emergency room.

Lisa Safaeinili, executive director of the Westminster Free Clinic in Thousand Oaks, praised the planned expansion, saying it will provide another option to people who currently have a very short list of healthcare choices. But it won’t help everyone, she said, noting that any co-pays are too much for many of the people who rely on the free clinic.

“Our particular population,” she said, “will still fall through the cracks.”